Screening practices and risk assessment for maculopathy in pentosan polysulfate users across different exposure levels

Kwon HY, Kim J, Ahn SJ · Scientific Reports

Maculopathy risk rose with cumulative dose: hazard ratios of 1.55 (50–500 g) and 1.66 (500 g or more) versus minimal exposure, with 9.0% cumulative incidence of maculopathy excluding common macular diseases in the highest-dose group — yet only about half of high-exposure users had ever had a monitoring eye exam.

Population

133,762 South Koreans starting oral PPS 2012–2021, nationwide claims database

Intervention

Oral PPS, stratified by cumulative dose: under 50 g, 50–500 g, and 500 g or more

Comparator

The minimal-exposure (<50 g) group

Limitations

Claims-code diagnoses without image review; 500 g of cumulative exposure equals roughly four and a half years of standard daily oral dosing, orders of magnitude beyond any injection course.